Organization
ITS A PASSION ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGO ELISHA DAWSON (OWNER)
(414) 732-4485
Entity
Organization
Contact information
Practice address
8487 KETTLE MORAINE DR, KEWASKUM, WI 53040-9213
(414) 732-4485
Mailing address
8487 KETTLE MORAINE DR, KEWASKUM, WI 53040-9213
(414) 732-4485
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
05/16/2024
Last updated
05/16/2024
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